Slow and inadequate implementation causes greater inequity and reduced quality in emergency psychiatric services. This symposium is based on five recommendations to improve health intervention research and implementation, presented by Professor Emma Mcginty (PhD), the leader of the Lancet Psychiatry Commission to transform implementation in mental health. This presentation will introduce each of these recommendations: I) integrate research into clinical practice to ease implementation II) embed equity in mental health intervention research III) use complexity science and bottom-up approaches to improve relevance of science and implementation IV) base implementation less additional methods beyond traditional RCT-based research V) use a transdisciplinary approach in development and implementation of research on new interventions.

None Declared

If untreated, mental health disorders are a leading cause of premature death due to physical illness and suicide. Typical onset is around the age of 15, and about 75% emerge by the age of 25. Thus early diagnostics and treatment to prevent chronic outcomes by early interventions is indispensable. We set up an intervention project in Frankfurt/Main, Germany, focusing on this vulnerable group aged 18 to 29.

The project aims to assess if a low-threshold, early-on psychosocial consultation model significantly reduces early symptoms of mental disorders among young adults and to evaluate whether community-based consultations reduce stigma and increase early service utilisation. We intend to measure changes in mental health literacy. Alongside consultations, we identify cooperation partners and give workshops to raise awareness and reduce stigma.

A team of university psychologists and psychiatrists developed the project with community organisations and local foundations. Consultations take place in a non-stigmatizing, informal setting: the space is not within a clinic, centrally located and easily accessible. Services may be utilised anonymously and without registration of health insurance. We offer qualified diagnostics, brief solution-focused counselling, psychoeducation, early pharmacological treatment, group therapy and referral pathways to specialised care when needed. Using questionnaires, we will refine the program for potential up-scaling. Since September 5th, 2024, 12 patients aged between 17 and 34 years have already made use of the offer. Pre-intervention symptoms at baseline were initially assessed while post-intervention symptom assessments will take place 3 months later. Qualitative data will be analysed via thematic coding. Quantitative data for symptom alteration will be collected via Likert scales and analysed using paired t-tests and regressions. Qualitative feedback will be collected via surveys. We hypothesise that psychological well-being will improve post-intervention. Additionally, we expect an increased mental health literacy, alongside increased utilisation and acceptance of mental health services.

Yet to follow.

Community-based mental health consultations represent a feasible early intervention strategy for young adults. Results are expected to support expanding such models to other community structures and refining protocols for scalability. We aim to optimise service delivery, assess long-term outcomes, and examine cost-effectiveness for potential implementation on a broader scale.

None Declared

Job satisfaction is undoubtedly one of the concerns that has given rise to the most research since the middle of the 20th century. It is one of the particularly important concepts in the study of ‘health at work’ determinants. Its evaluation may appear to be necessary in order to set up relevant preventive actions. However, in Tunisian hospitals, job satisfaction remains poorly assessed. It is therefore crucial to assess it and study its factors in order to promote a balanced work environment.

Assess the overall job satisfaction of health care workers (HCW) at Charles Nicole Hospital using a validated questionnaire in French and Arabic.

This was a cross-sectional study of consenting HCW at Charles Nicole Hospital during the period from 1st September to 31st October 2024. Data were collected by means of a 63-item questionnaire, which assessed participants’ well-being and satisfaction on several aspects using a four-point Likert scale with six dimensions: Perceived superior support at work, affective commitment, emotional exhaustion, work/family conflict, extrinsic efforts and job satisfaction. The questionnaire had good internal consistency and was validated in French and Arabic. The questionnaire was self-administered to the HCW who went to the occupational health department for a medical check-up.

A total of 30 participants were enrolled. The mean age was 45.37 ± 10.3 years, with a sex ratio of 2.3 (F/H). Eighty-six percent were married and had at least one child. The most common occupational category was senior technician (34%). The average length of service was 17.27 ± 10.1 years. Laboratory departments and surgical departments were the most represented in 32% and 26% of cases respectively. Eighty percent of HCW worked full-time. Teamwork was reported in 53% of cases. The number of staff in the work team was less than 10 in 83.4% of cases. Perceived support from a superior was found in 40% of cases. Nearly 20% of cases showed emotional exhaustion secondary to their work and 34% showed extrinsic strain. Affective commitment was present in 36.7% of cases. Only 14.3% of cases showed work/family conflict. Overall, 73.3% of HCW were satisfied with their work.

This study highlights the importance of working conditions and organisational support in the well-being of HCW. Job satisfaction, although mainly present, is put to the test by a mismatch between professional and personal life, extrinsic efforts and a lack of hierarchical support. Emotional exhaustion is a major warning sign, showing that better care and support could improve both emotional commitment and job satisfaction.

None Declared

Quality of life is a subjective evaluation that individuals make of the various aspects of their lives in relation to their health. Head and neck cancers and their surgical treatments, such as total laryngectomy (TL), change some of the most basic and important vital functions and can affect patients’ lives in many ways. The patient’s altered appearance, loss of their normally used voice, difficulty swallowing, and certain complications from this kind of surgery, all contribute to impaired quality of life by imposing daily limitations. Despite these considerable impacts, there is no or only very limited research addressing the quality of life of patients post- TL, highlighting the need for further exploration into this critical aspect of patient care.

The purpose of this study was to assess self-perceived quality of life in Tunisian male patients who underwent TL for laryngeal cancer.

A descriptive cross-sectional study was conducted in the Head and Neck Carcinologic Surgery Department at Salah Azaiez Institute. Socio-demographic and clinical data were gathered. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N35), Depression, Anxiety and Stress scale, and Voice Handicap Index.

The study involved 30 male participants with a mean age of 62 years (±10 years). The mean EORTC QLQ-H&N35 total score was 60 ± 9.8. The areas of EORTC QLQ- H&N35 score most affected are shown in Figure 1.

Our results indicated that younger patients (P=0.002) and those from rural areas (P=0.04) tended to report better quality of life scores. Additionally, higher socioeconomic status was linked to a reduced quality of life (P=0.006). Patients who were classified as (N+) according to the Tumor, node and metastasis (TNM) staging, showed significantly better quality of life (P=0.004).A higher quality of life was significantly correlated with primary TL (P=0.004), while a lower quality of life was significantly associated with TL followed by radio-chemotherapy (P=0.005).Depression, anxiety, and stress were significantly correlated with poorer quality of life (P=0.002, P=0.001, P=0.001, respectively). Finally, lower quality of life scores were strongly associated with the Voice Handicap Index score (P=0.0001).

Figure 1. Distribution of patients according to their EORTC QLQ- H&N35 scores.

Image 1:

In conclusion, patients who underwent TL for laryngeal cancer seem to exhibit an impaired quality of life, with factors like age, socioeconomic status, treatment type, voice handicap and psychological distress likely playing an important role. These findings underscore the need for comprehensive post-surgical care aiming at improving quality of life for people affected by this condition.

None Declared

Teacher burnout is a pervasive challenge across the global educational sector, profoundly impacting educator well-being and the overall quality of education. A robust body of research highlights the link between organizational factors and burnout, underscoring the urgent need for an in-depth understanding of these dynamics across different cultural contexts.

This systematic review aims to delineate how workload and social support dynamically influence teacher burnout. Through a detailed examination of the complex interrelationships among these factors, we endeavor to elucidate the underlying mechanisms by which they influence teachers’ emotional and psychological health, thereby providing critical insights into potential evidence-based interventions.

We synthesized findings from a total of 40 relevant studies (35 cross-sectional and five longitudinal studies), adhering to the 2020 PRISMA guidelines. We utilized the Newcastle-Ottawa Scale for quality assessment due to its rigorous criteria, examining the impact of workload and social support on teachers’ stress levels across diverse educational settings.

High workload and insufficient social support were identified in 75% of the studies as significant predictors of emotional exhaustion among teachers globally. Excessive workloads were correlated with increased burnout levels, which negatively affected their mental health and job satisfaction. Conversely, strong social support networks, including collegial relationships and administrative support, were found to effectively mitigate burnout, bolstering teachers’ resilience and overall well-being. Furthermore, the review underlined that the quality of the evidence was moderate, highlighting the need for further, more robust research.

This review confirms the complex interactions within organizational dynamics that contribute to teacher burnout. It underscores the critical need for tailored interventions, such as professional development in stress management and policies that foster supportive work environments. By strategically addressing workload challenges and enhancing social support, stakeholders can significantly improve teacher well-being and reduce burnout risks globally.

None Declared

Clozapine is an atypical and complex antipsychotic that appears to benefit from actions on multiple neurotransmitter systems. While its mechanisms of action are not fully understood, this broad spectrum of activity accounts for clozapine’s superior efficacy in treating refractory schizophrenia and other conditions.

The aim of this paper is to review the main indications of clozapine and its applications in clinical practice, as well as to highlight key considerations for its safe and effective management.

A systematic review of the scientific and clinical literature on clozapine was conducted. The review included databases such as PubMed and Cochrane, covering articles from the past 20 years. The scientific evidence obtained was analyzed and synthesized.

Findings indicate that clozapine remains the treatment of choice for patients with treatment-resistant schizophrenia, showing a superior response rate compared to other antipsychotics. Additionally, its effectiveness in reducing suicidal behaviors in patients with schizophrenia and related disorders has been identified. The indications also extend to psychosis in Parkinson’s disease, substance use disorders, and a wide range of psychiatric and neurological disorders.

Clozapine is essential in the treatment of refractory schizophrenia and in reducing suicide risk. Its broad mechanism of action, affecting multiple neurotransmitters, allows its use in secondary psychotic disorders and complex comorbidities, such as Parkinson’s disease. However, its use is associated with significant risks, necessitating rigorous monitoring of adverse effects.

None Declared

The paradigms of diagnosis and evaluation in mental health are changing due to the incorporation of artificial intelligence (AI) into other fields. Understanding mental health conditions is greatly aided by insights from neuroscience, immunology, social and clinical psychology, and cultural theories. According to Martyn Evans’ commentary, interdisciplinary work generates new issues and solutions while multidisciplinary work preserves unique viewpoints. In this sense, the interdisciplinary field of psychoneuroimmunology has contributed significantly to our understanding of mental health. It has also contributed significantly to the interplay between the immune system, the endocrine system, and the nervous system. This field could rapidly emerge as a key component of integrative diagnosis and assessment.

This review emphasizes the need for comprehensive biopsychosocial assessment frameworks and the importance of harmonizing disciplines through multidisciplinary and interdisciplinary methodologies to enhance diagnostic possibilities via AI.

A critical review of clinical psychology was conducted, as well as a discussion of the necessity of using integrative methodologies in order to address the interconnected nature of both medical diseases and mental disorders, in light of recent advancements in artificial intelligence.

It has been explored how PNI can serve as an interdisciplinary ground for cross-disciplinary dialogue and how stakeholder perspectives may resolve complexities in clinical assessment and psychiatric diagnosis through extending PNI with AI and applications. Integrating AI into PNI is crucial for revolutionizing mental health care, utilizing machine learning to consolidate diverse data streams and predict outcomes.

Lastly, it was outlined some pragmatic frameworks for clinical assessment, taking into account time, budget constraints, and stakeholder interests. Ethical, governance, and practical challenges of AI integration are discussed. The paper proposes innovative AI-driven enhancements in psychiatric assessment, diagnosis, and treatment, fostering transformative developments in clinical psychology and promoting a humanistic approach to mental health care.

None Declared

In the modern world, the problem of infertility is becoming more significant. In particular, the number of women with experience of miscarriage is increasing. Problems with pregnancy, frustration of the desire to become a mother influence the formation of a woman’s motherhood and self-image as a mother, which can lead to intrapersonal problems of a woman and to a distortion of care practices and child-parent relations in relation to the future child.

To study the features of the self-image as a mother in women with experience of miscarriage.

A pilot study was conducted. Two methods were used in this study: “Unfinished sentences” (Sachs-Levy, mod. A.G. Dolgikh, 2018), method of semantic differential (spaces proposed by A.G. Dolgikh, 2018).

The study sample consists of 3 groups: 30 women with experience of miscarriage for medical reasons aged 25 to 35 years; 30 women aged 25 to 30 years who have no experience of pregnancy; 30 women raising children under the age of five.

The results of attitudes peculiarities psychodiagnostic study towards motherhood in women using the “Unfinished Sentences” technique demonstrate that generally more expressed positive attitude towards motherhood in general and attitude towards themselves as a future mother for the group of women with experience of miscarriage compared to other groups of women.

The self-image as a mother using the semantic differential method showed that the semantic universals of this image for both the entire sample and for a group of women with miscarriage experience are adjectives “reliability”, “caring”, “tenderness”.

The self-image as a mother semantic profiles comparative analysis revealed significant differences in the indicators of this image among the study groups. Women with the experience of miscarriage characterized themselves as more warm, more soft, more caring and more harmonious (p<0.05) compared with women from other groups. They also perceive the image of themselves as a future mother as lighter, more reliable, more anxious and more affectionate than women without experience of pregnancy and motherhood (p<0.05).

Women experienced miscarriage are characterized by more idealized ideas about motherhood probably due to problems with pregnancy and frustration of the desire to become a mother.

None Declared

Suicide represents a significant and growing public health challenge in Brazil, reflecting a complex interplay of social, economic, and mental health factors.

The increasing rates of suicide highlight the need for targeted interventions and policies. Understanding the demographic characteristics associated with suicide, particularly in relation to sex and age, is crucial for developing effective prevention strategies and health policies. This study utilizes data from the 2024 epidemiological bulletin, “Panorama dos Suicídios e Lesões Autoprovocadas no Brasil de 2010 a 2021.”

This study aims to provide an analysis of the mortality rates from suicide in Brazil for the year 2021. The primary focus is on exploring the distribution of suicide rates by sex and age group, as well as evaluating the proportional mortality in relation to the total number of deaths in the country.

The study utilized data sourced from the Mortality Information System (SIM) and the aforementioned epidemiological bulletin, which compiles comprehensive mortality data across Brazil. We analyzed the rates of mortality from suicide, categorizing the data by age groups: 05 to 14 years, 15 to 19 years, 20 to 29 years, 30 to 49 years, 50 to 69 years, and 70 years and older. The analysis further differentiated the data by sex, allowing for a nuanced understanding of demographic variations.

In 2021, Brazil reported a total of 15,507 deaths attributed to suicide. Of these, 12,072 (1.21% proportional mortality) were male, and 3,431 (0.43% proportional mortality) were female, indicating a substantial gender disparity in suicide rates. The mortality rates from suicide per 100,000 inhabitants varied significantly by age group: 0.7 for males and 0.9 for females in the 05 to 14 years age group; 9.3 for males and 4.5 for females in the 15 to 19 years group; 14.6 for males and 3.9 for females in the 20 to 29 years group; 14.9 for males and 3.8 for females in the 30 to 49 years group; 15.4 for males and 3.8 for females in the 50 to 69 years group; and 18.1 for males and 2.9 for females aged 70 years and older. Notably, among the leading causes of death, suicide ranked 11th for the 05 to 14 years age group (3.41%), 3rd for the 15 to 19 years age group (6.90%), and 4th for the 20 to 29 years age group (5.56%). These figures underscore the significant impact of suicide on young populations.

The high mortality rate from suicide in Brazil underscores the urgent need for public health policies focused on suicide prevention. Effective interventions should include mental health support, community outreach programs, and increased awareness campaigns aimed at reducing the stigma around mental health issues. By addressing the underlying social and economic factors contributing to suicide, Brazil can improve health outcomes and enhance the quality of life for at-risk populations.

None Declared

Older patients in palliative care often experience considerable stress due to physical, emotional and existential factors. Previous research has identified cortisol, a glucocorticoid hormone, as a key biomarker for stress assessment. This pilot study aimed to investigate the potential of hair cortisol as a potentially objective stress biomarker in a specific population (aiming for a broader aplicability), as well as to explore cognitive changes in older palliative patients using the Mini-Mental State Examination (MMSE-2).

This study objectives were to (1) assess changes in hair cortisol levels and cognitive function in older palliative care patients over three weeks of hospitalization and (2) evaluate the suitability of hair cortisol as a short-term stress biomarker in this patient group.

This monocentric pilot study included 19 patients from different palliative care hospital services in Croatia, gathered via a convenience sampling approach with strict inclusion/exclusion criteria. Hair cortisol levels were measured at baseline and after three weeks using an enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed using the 16-point MMSE-2. Statistical analyses included paired t-tests and linear regression, and significance was set at p<0.05.

A statistically significant increase in mean hair cortisol levels was observed after three weeks of hospitalization (p=0.007), suggesting heightened stress over time. In contrast, MMSE-2 scores showed no statistically significant change (p=0.064), indicating no detectable cognitive decline within the study period. No significant correlations were found between cortisol levels and MMSE-2 scores at either time point, and differences between male and female patients were not statistically significant.

The findings support the potential use of hair cortisol as a biomarker for stress in palliative care settings, especially for tracking the transition from acute to chronic stress. However, MMSE-2 may not be sensitive enough to detect cognitive changes over short time spans in this patient group. Consequently, further research with larger samples is needed to validate hair cortisol as a practical tool for monitoring stress and to explore its clinical implications for improving palliative care outcomes.

None Declared

Psychiatric disorders,such as anxiety,depression,bipolar disorder and schizophrenia,remain major global health challenges. Although prevalence has not recently increased, mental health care struggles with early diagnosis, real-time monitoring and personalized treatment. Traditional methods, relying on self-reports and clinical assessments,often miss the dynamic nature of these conditions.AI and wearable technology offer a new approach, enabling continuous data collection and real-time analysis to improve early detection and optimize patient care

This study aims to assess the role of AI-driven wearables in diagnosing,monitoring and managing psychiatric disorders by:

Evaluating AI’s effectiveness in predicting psychiatric episodes using wearable sensor data

Exploring clinical applications to improve patient outcomes

Identifying challenges and ethical considerations in the broader use of this technology in mental healthcare

A systematic review of studies(2018-2023)on AI and wearable technology in psychiatry was conducted using PubMed, Scopus and Google Scholar.Studies were selected based on their focus on AI-driven wearables for predicting or managing psychiatric conditions.These devices typically captured physiological and behavioral data,such as heart rate variability,sleep patterns and movement.The accuracy of AI algorithms in predicting psychiatric episodes was compared to traditional methods,with statistical analysis used to assess outcomes

The review showed that AI-driven wearable devices significantly improved early detection and prediction of psychiatric episodes,with accuracy rates over 80% for depression, anxiety and bipolar disorder.Wearables,combined with AI algorithms, effectively monitored physiological data like heart rate and sleep patterns,providing real-time insights for personalized, timely interventions.For example,changes in sleep and activity levels,alongside heart rate variability,strongly predicted depressive episodes.In patients diagnosed with bipolar disorder,AI detected mood swings early by analyzing behavioral data from wearables,enabling stabilization.Wearables also helped monitor medication adherence and reduced relapse rates in patients diagnosed with schizophrenia by identifying early signs of psychotic episodes

AI-driven wearable technology has the potential to transform psychiatric care by enabling continuous monitoring and personalized interventions.These tools enhance early detection and prediction of psychiatric episodes,offering a more dynamic approach than traditional methods.However,challenges such as data privacy, ethical concerns and the lack of regulatory frameworks must be addressed before widespread clinical use.Further research is needed to refine AI algorithms,validate the long-term effectiveness of wearables and ensure patient safety through regulations and privacy protections

None Declared

Substance use and mental health problems commonly co-occur. Yet, people experiencing both problems commonly face barriers to getting the support they need and experience increased physical morbidity and premature mortality, compared to those with only one problem. In the UK, current guidance on treatment of co-occurring alcohol and mental health problems exist which set out standards for ways of working with this population, and how and where treatments should be offered.

Through a secondary qualitative analysis and a systematic review, we aimed to determine the extent to which the UK guidance for care for people with co-occurring problems is being implemented.

A secondary qualitative analysis was conducted of interview transcripts from people with co-occurring depression and hazardous/harmful alcohol (N = 39). In addition, a systematic review was conducted to identify studies published in the UK since 2017 which focueds on treatment for adults with co-occurring substance use and mental health problems. For both data sources, a deductive coding framework was developed based upon the UK guidance and a thematic analysis was applied.

The qualitative analysis identified four key themes from the service user perspective: Wrong doors and stigma; Responsibility and coordination of care; ‘Don’t discharge me’ and Impacts of gaps between services. The review identified three main themes: Challenges to care for co-occurring conditions; Integration of care; and System and structural level barriers. Both studies showed that making initial contact with services was challenging, as was continued engagement with treatment. Staff attitudes and knowledge were important, because the therapeutic alliance had a significant impact on treatment outcomes and recovery. Stigma, both intrinsic and extrinsic, was identified as a barrier to accessing, engaging with, and delivering support. Both studies found evidence of inconsistent treatment offerings and conflicting advice or support, especially around the most appropriate way to treat co-occurring conditions. Barriers and facilitators were evident across individual, organisational and systems levels. Findings indicate that people are often not receiving the care they need in the ways in which guidance recommends.

The results suggest that despite existence of current guidance in the UK, implementation is inconsistent. This work has identified specific areas for improvement around access to treatment and a need for better coordination and integration of care. It highlights the need to explore how guidance can be better embedded in current practice to improve experiences and outcomes for this population.

None Declared

Depression is a prevalent yet frequently underdiagnosed condition in patients with dementia, exacerbating cognitive decline and emotional health. The combination of depressive symptoms with dementia-related cognitive deficits complicates accurate diagnosis and management of depression in this group of patients. Improved diagnostic instruments specifically designed for dementia patients are essential for improving detection and treatment outcomes.

To evaluate the prevalence and diagnostic challenges of depression in dementia, focusing on symptom overlap. Additionally, it aims to assess the efficacy of diagnostic tools and management strategies to improve patient outcomes.

A systematic review of the literature was performed to evaluate the prevalence, symptomatology, and diagnostic difficulties of depression in dementia.

The results reveal a substantial intersection between the cognitive and emotional symptoms of dementia and depression, encompassing apathy, anhedonia, and mood disorders. The coexistence of these symptoms frequently results in the underrecognition of depression or its misattribution to the dementia process. Instruments such as the CSDD and NPI showed higher sensitivity in identifying depression among dementia patients. Pharmacological therapies, including psychotherapy and individualized behavioral interventions, demonstrated improvements in mood and cognitive function; nevertheless, therapeutic success fluctuated according to the stage of dementia.

Depression in dementia patients has distinct diagnostic and treatment issues owing to symptom overlap and cognitive deterioration. Enhanced diagnostic instruments, including the CSDD, NPI, and GDS, provide superior distinction of depression symptoms from dementia-related deficits. Early recognition and tailored treatment strategies, integrating pharmaceutical and behavioral interventions, may alleviate depression symptoms and enhance overall patient outcomes. Interdisciplinary collaboration is crucial for enhancing care.

None Declared

During the last decades, clinical practice for patients with first-episode psychosis has shifted to early intervention programmes that aim to accelerate access to treatment and also ensure adherence to antipsychotic (AP) medication. However, recent pragmatic, randomised controlled trials still report very high discontinuation rates of the initially prescribed AP treatment due to lack of efficacy, side effects, or other reasons. The CLinical Utility of early intervention including the 5-Step Precision Medicine (5SPM) Method in first-episode Psychosis (CLUMP) Project is a translational research initiative focused on improving adherence to antipsychotic medications and therapeutic outcomes in first-episode psychosis patients using pharmacogenetics. We present a preliminary descriptive analysis of this project based on a retrospective cohort.

• - To establish discontinuation rates of the first antipsychotic treatment administered to patients with a first-episode psychosis before the implementation of the CLUMP project.

• - To describe reasons for such discontinuations.

We conducted an observational study on a consecutive, retrospective cohort of 49 patients who experienced a first-episode psychosis in Salamanca, Spain, before the implementation of CLUMP, in order to subsequently determine the impact this project might have on AP treatment discontinuations. We reviewed their clinical records to collect variables such as sex, age, first prescribed antipsychotic medication, and any discontinuation within the first year post-treatment initiation, recording reasons for discontinuation or treatment changes, such as lack of efficacy, non-adherence, side effects, or others.

Of the 49 patients included in the analysis, 7 were excluded due to inaccessible information, leaving a final sample of 42 (26 males). Age ranged between 16 and 48 years, with a mean age of 25.9 (9.2). 38 patients (90.47%) discontinued treatment within one year, with similar rates in men (92.3%) and women (87.5%) (See Figure 1). 16 reported side effects as the main reason for discontinuation, 1 lack of efficacy, 9 lack of adherence, and 12 other reasons (Figure 2). Among the 16 who discontinued due to side effects (Figure 3), 3 experienced extrapyramidal symptoms, 3 drowsiness, 3 sexual dysfunction, 2 hyperprolactinemia/galactorrhea, 1 metabolic syndrome, 1 excessive salivation, and 3 did not specify the symptom.

Image:

Image 2:

Image 3:

Most patients in our sample discontinued antipsychotic treatment within the first year post-treatment initiation, mainly due to side effects. These data indicate the need to restructure clinical care for patients with first-episode psychosis to ensure adherence to AP and reduce trial-error approaches to treatment choice from start. The CLUMP project proposes an individualised strategy, based on pharmacogenetics, to improve therapeutic adherence and outcomes in patients with FEP.

None Declared

While many evidence-based mental health prevention, promotion, and treatment interventions exist, they are poorly and inequitably scaled across populations. Too often, research produces interventions and implementation strategies that are difficult to scale due to misalignment with culture, policy, system, community, provider, and individual realities. This presentation will introduce the Lancet Psychiatry Commission on Transforming Mental Health Implementation Research, which makes five recommendations to transform the research enterprise to produce more actionable evidence and address the mental health implementation gap. These recommendations focus on strategies for integrating research and real-world implementation; centering health equity in mental health intervention and implementation research; using a complexity science lens to study strategies for scaling effective interventions; expanding research designs beyond the traditional randomized clinical trial; and using transdisciplinary approaches. The Commission also made cross-cutting recommendations related to elevating work on mental health systems and policy and the importance of strengthening mental health implementation research globally.

None Declared

Cannabidiol (CBD) is a non-psychoactive cannabinoid with therapeutic potential in various fields, such as its effect on mental health or antiepileptogenic, among others. For this reason, the interest in research on the potential effects of this substance is booming and the sale and consumption by the general population is increasing.

To describe the observed effects of CBD use during treatment with electroconvulsive therapy (ECT).

To describe in detail the clinical case and to correlate the changes observed in the seizures and the electroencephalogram (EEG) of the ECT sessions when the patient performed concomitant consumption of CBD, in addition to the changes at the clinical level that he experienced during this period.

The subject is a 47-year-old man who required admission for a psychotic decompensation of his schizoaffective disorder bipolar subtype. In recent years, he had no adherence to psychopharmacological treatment or follow-up, and reported self-medicating with CBD cigarettes in varying amounts (he reported 5 to 15 units/day). During admission, pharmacological treatment was instituted with poor response and an acute course of ECT was performed due to a history of good response in a previous episode 10 years ago and the patient’s preference. He remained abstinent from CBD during hospitalization and it was agreed to remain non-consuming at discharge. He presented progressive improvement in the clinical signs from the 4th session, with remission in the 7th session. Upon discharge, it was agreed to perform consolidation ECT on an outpatient basis, initially with weekly sessions and then every two weeks.

From the 2nd outpatient session, a worsening of motor and electroencephalographic seizures was observed in the ECT sessions. A possible relapse into CBD use, which the patient denied, was explored. After the 3rd outpatient session, the patient recognizes relapse into CBD consumption with occasional consumption. During the following 2 sessions, the deterioration in the quality of the EEG pattern progresses and it is decided to interrupt ECT treatment due to the absence of seizures in EEG recording, coinciding with an increase in the daily amount of CBD consumed.

There is little literature on the management of the effects of CBD in ECT treatment. The observations in this clinical case provide valuable information about the combination of CBD and ECT that can be useful to other professionals with similar cases.

None Declared

Over 55 million people currently have Alzheimer’s disease (AD), with estimates predicting a rise to 78 million by 2030. The burden of AD impacts not only the affected individuals but also their families and society due to the increasing care demands. Caring for people with AD is emotionally and physically taxing. The World Health Organization emphasizes the need for caregiver support.

This study aims to understand the caregiving experiences and needs of family caregivers for individuals with AD.

A qualitative descriptive design was used. Data were collected from 23 caregivers at a university hospital’s geropsychiatric clinic. Participants were family members caring for individuals with AD for at least four hours per day. Interviews were analyzed using content analysis.

Sample Characteristics: The mean age of participants was 57.82 and 57% were female. More than 85% lived with the care recipient, the average caregiving duration was 81.34 hours per week. The following themes were extracted from data collected during the interviews (Figure 1).

Stuck in Caregiving: Participants found caring for loved ones with AD to be an unexpected challenge. Many initially missed the onset of AD due to their loved ones’ previous abilities. Family conflicts over caregiving tasks, shaped by differing spiritual and cultural beliefs, were common. Caregivers faced difficulties, especially with stubborn behavior and personal care tasks.

A Life in Metamorphosis Most participants experienced profound changes in their personal lives, including social isolation and emotional turmoil. Half of the participants found meaning in caregiving, gaining new perspectives on life.

Caregivers identified specific needs, including psychosocial support, disease education, in-home care, and adult daycare services.

Image 1:

The gradual onset of AD delays symptom recognition, making diagnosis hard for families to accept. As caregiving demands increase, conflicts between caregiving and personal responsibilities cause stress and neglect of personal life. Despite these challenges, many caregivers find personal growth. They seek temporary care options, home assessments, and improved access to education and counseling, highlighting areas for better caregiver support.

None Declared

The 3-dimensional (3D) marker-less motion capturing (MoCap) systems are an emerging technique in movement analysis. Recent studies have shown that such MoCap assessment have great potential for accurate and objective assessment of motor alterations in psychiatric patients. Gait as a fundamental gross motor function is the final motor outputs of a complex network integrating sensorimotor systems, cognitive and affective stimuli. Understanding gait alterations in catatonia patients can provide insights into their sensorimotor dysfunction and help in diagnosis and treatment in future.

The primary objective of this study is identifying gait alterations using a 3D optical marker-less MoCap system in catatonia patients (CAT) compared to non-catatonia controls (Non-CAT). We hypothesize that there will be significant reduction in the spatiotemporal parameters of gait, such as speed, stride width, stride length, step length, and cadence as well as increased gait instability in CAT group. Moreover, these alterations will be correlated with general psychomotor slowing.

In this cross-sectional study, we examined a total of 61 patients with and without catatonia diagnosis (CAT; n=22, Non-CAT; n=39) according to ICD-11. Participants were assessed with the Positive and Negative Syndrome Scale (PANSS), Northoff Catatonia Rating Scale (NCRS), the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF). We conducted clinical psychomotor examination with the Heidelberger Neurological Soft Sign Scale (NSS), Salpêtrière Retardation Rating Scale (SRRS) and Unified Parkinson Disease Rating Scale (UPDRS). Gait analysis were performed using a marker-less MoCap system with 8 cameras (Qualisys, Goeteborg, Sweden). Participants walked on a marked path (18 m) with a self-selected tempo during the experiment. The spatiotemporal parameters (STP) of gait were obtained automatically through Theia Software.

The two groups did not differ in age, sex, or BMI. The CAT group showed higher scores in PANNS, BPRS, NCRS and GAF (p< 0,05). We found a statistically significant difference in clinical psychomotor parameters in NSS, SAS and UPDRS between the two groups (p <0,05) and more specifically in gait subdomain of each scale. No differences were found in any of STP of gait or gait instability measurements after controlling for covariates (age, sex, BMI and medication).

Image 1:

This study exhibit a significant difference between the results of clinical psychomotor assessments and objective gait analysis through marker-less MoCap. This discrepancy suggests a potential overestimation of gait alterations in clinical evaluations. The findings underscore the importance of integrating advanced 3D MoCap technologies into the psychiatric assessment to enhance our understanding of gait alterations in mental disorders.

None Declared

The presentation will summarize recent findings on the role of the two domains of negative symptoms (motivational impairment and expressive impairment) and social cognition as mediators of the impact of neurocognitive impairment on functional outcomes in people living with schizophrenia (PLWS).

One hundred and fifty subjects from 8 different European centers were recruited. Our data showed that the expressive impairment predicted global functioning and together with motivational impairment fully mediated the effects of neurocognition on the same outcome. Motivational impairment was a predictor of personal and social functioning and fully mediated neurocognitive impairment effects on the same outcome. Both motivational and neurocognitive impairments predicted socially useful activities, and the emotion recognition domain of social cognition partially mediated the impact of neurocognitive deficits on this outcome.

Our results indicate that pathways to functional outcomes are specific for different domains of real-life functioning and that negative symptoms and social cognition mediate the impact of neurocognitive impairment on different domains of functioning. Our results suggest that psychosocial interventions should target both negative symptoms and social cognition to enhance the functional impact of cognitive remediation.

A. Mucci Consultant of: Angelini, Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka Pharmaceutical, Pfizer, Pierre Fabre, Rovi Pharma and Boehringer Ingelheim.

The inconsistency in cancer incidence and mortality rates in terms of cancer site reported among patients with schizophrenia has been an interesting topic in epidemiology, and additional studies are necessary to gain a more comprehensive understanding.

Due to the inconsistency of the evidence about the cancer risk among patients with schizophrenia, the aim of this study was to analyse cancer mortality and morbidity in patients with schizophrenia treated in a single centre in Lithuania during the study period of 1992-2020.

A retrospective cohort study was conducted in Vilnius Republican Psychiatric Hospital, the biggest specialised psychiatric hospital in Lithuania, with approximately 5000 hospital admissions annually. The patients’ cohort was established by identifying all patients with the diagnosis of schizophrenia (ICD-10 code F20) in the hospital database from 1 January 1992 until 31 December 2017. The cancer cases and cancer deaths in the cohort were identified in the Lithuanian Cancer Register through linkage procedures. The analysis of risk was based on a comparison of observed and expected numbers of cancers and deaths. Expected number of cancer cases were calculated by multiplication of the exact person-years under observation in the cohort by sex, calendar year and a 5-year age-group-specific national incidence and mortality rate. All statistical analyses were carried out using STATA 15 statistical software.

During the follow-up, out of 8553 patients, 673 cases of cancer were diagnosed in both sexes. Statistically significantly lower risk for overall cancer incidence was observed in men (SIR 0.74, 95% CI 0.66-0.83), but not in women (SIR 1.07, 95% CI 0.97-1.18). We observed lower risk for pancreatic cancer (SIR 0.36, 95% CI 0.14-0.96), non-melanoma skin cancer (SIR 0.54, 95% CI 0.33-0.88) and prostate cancer (SIR 0.69, 95% CI 0.55-0.87) in men and higher risk for malignant neoplasm of liver (SIR 2.58, 95% CI 1.53-4.36) and skin melanoma (SIR 2.03, 95% CI 1.12-3.66) in men and for breast cancer (SIR 1.38, 95% CI 1.14-1.66) and corpus uteri cancer (SIR 1.56, 95% CI 1.18-2.07) in women (Table 1). Statistically significant lower overall cancer mortality risk was observed in men (SMR 0.82, 95% CI 0.70-0.96), while in the women’s group, risk of cancer deaths was significantly higher compared to the general population (SMR 1.28, 95% CI 1.11-1.48).

The current results of our study indicate lower risk of overall cancer incidence and mortality in male patients with schizophrenia, while female patients had a higher mortality risk, alongside variations in the risk of different cancer types. This information is important not only for patients, but for healthcare specialists to develop effective disease-specific preventive interventions and programmes.

None Declared